Working time use and division of labour among nurses and health-care workers in hospitals - a systematic review

AIMS: This systematic review aimed to synthesise the existing evidence of working time use and the division of labour among nurses and health-care workers in hospital wards. BACKGROUND: The environment of nursing work is changing. Health systems are becoming more complex and costly, and highly skilled health-care professionals are transferring to new, more demanding tasks. Changes require a division of labour that is based on the efficient use of working time. EVALUATION: Sixteen studies were identified for the final analysis through a systematic search. KEY ISSUE: The use of working time was examined mainly through six categories: direct care, indirect care, documentation, unit-related work, personal time and non-nursing duties. The division of labour was examined from the perspective of different occupational groups. CONCLUSIONS: Despite nurses' different educational backgrounds, certain similarities could be observed. All working groups seem to spend less than half of their working time in direct patient care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers could influence the increasing nursing workload by supporting the right division of labour and focusing the nurses' working time use so that it benefits the patient.